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Flexible Spending Accounts: What’s Eligible?
The IRS defines eligible health care expenses as amounts paid for the diagnosis, cure, mitigation or treatment of a
disease, and for treatments affecting any part or function of the body. The expenses must be primarily to alleviate a
physical or mental condition or illness. This list is not meant to be all-inclusive.

Eligible Expenses
DENTAL SERVICES
PRACTIONERS
Dependent Care
Assistance Program
Under DCAP, the IRS allows eligible
employees to pay for qualified daycare
expenses on a tax favored basis. The
MEDICAL TREATMENTS/PROCEDURES
participant and spouse must be
gainfully employed, seeking gainful
Alcoholism and Drug Addiction (inpatient MEDICAL EQUIPMENT, SUPPLIES and
employment, or in school for the
SERVICES
following expenses to qualify under
the plan.
The following is a sample list of
eligible and ineligible expenses.
Physical Examination (not employment-related) ELIGIBLE EXPENSES
Reconstructive Surgery (if medically necessary After-school care or extended day programs Learning Disability (special school/teacher) Amounts paid to babysitter inside or outside Prescribed Medical and Exercise Equipment Splints/Casts or Support Hose (if medically Weight Loss Programs (as prescribed by your Expenses paid to relative (e.g., parent or grandparent of participant for child care) Transportation Expenses (essential to medical OBSTETRIC SERVICES
Tuition Fee at Special School for Disabled Child Lamaze Class (child rearing classes excluded) Weight Loss Drugs (to treat specific disease) INELIGIBLE EXPENSES
Educational expenses—kindergarten, first OB/GYN Prepaid Maternity Fees (reimbursable Ineligible Expenses
The IRS does not allow the following dependent day care
LAB EXAMS/TESTS
expenses to be reimbursed under Sick employee (that is, care for a dependent
FSAs and HSAs. This list is not meant
to be all-inclusive.
Piano, dancing, art, ballet lessons.etc. VISION SERVICES
Activity fees Health care expenses for a dependent Insurance Premiums and Interest (allowed for Section 213d governs the eligible expenses
MEDICATION
Long Term Care Premiums (allowed for HSA) for HSA, FSA and DCAP plans. Publications
502 and 503 are written to help taxpayers
determine what qualified expenses can be
deducted on their income tax returns FSAs
and DCAP, respectively. They should not be
Swimming Lessons Teeth Whitening/Bleaching used as the sole determinant for what is
Over the Counter Medications (see reverse) reimbursable under these plans.
Over-The-Counter (OTC) Items
Effective January 1, 2011
Eligible OTC Medical Supplies: Itemized
Ineligible OTC Items:
receipt with claim request
Do not submit for
Adult incontinence products (e.g. Depends) Birth control products (e.g. prophylactics) reimbursement
Health monitors (e.g. blood pressure, cholesterol, HIV, thermometers) Supports/braces (e.g. ankle, knee, wrist, therapeutic glove) Please note that this is not a complete list, but is intended to provide Plan participants with
examples of OTC items that may be eligible.

OTC Drugs and Medicines Requiring a
Prescription
Acne medications Allergy & sinus medications (Benadryl, Claritin, Sudafed) Anti-itch medications (Caladryl, Cortizone) Gastrointestinal aids (antacids, anti-diarrhea medicines, laxatives – non-fiber, nausea Nasal sprays for congestion (e.g. Afrin) Pain relievers (e.g. aspirin, Excedrin, Tylenol, Advil, Motrin) Please note that this is not a complete list, but
is intended to provide Plan participants with
examples of OTC items that may be eligible.
To be reimbursed for these expenses, a
completed claim form must be submitted to
Dual-Purpose Items: Itemized receipt and
UAS along with one of the following:
Certification of Medical Necessity form
A customer receipt identifying the
required with claim request
name of the person for whom the
prescription applies, the date and
amount of the purchase, and an Rx
number; or
A customer receipt that reflects the
date and the amount of the
purchase, along with a copy of the
prescription.
Nasal strips & snore relief (e.g. Breathe Right) Vaporizers/humidifiers Vitamins/minerals/supplements

Source: http://www.uastpa.com/wp-content/uploads/2013/05/ReimbursableExpenses.pdf